Equine-assisted therapy (EAT) and equine-assisted psychotherapy (EAP). Never heard of them? You’re not alone. And yet, one would think that our veterinary profession would have at least some knowledge of equine therapy and equine psychotherapy.
Most of us would appreciate how effective pet as therapy (PAT) dogs are at lifting the mood of residents of care homes and helping young people with chronic medical conditions who require long-term care away from their homes.
There’s no doubt that in our very busy hospital I, as well as pretty much most of the other staff, will regularly pause to stick our noses into the kennel of a patient who wants to be stroked as much as we want to stroke them. It’s the perk of the job and it doesn’t go unused!
I shouldn’t envy my ward nurses when I see that they are on the cat ward for the week, where cat-friendly music plays at the same BPM as a relaxed cat, blankets are plentiful and sprayed with pheromones, the patients have somewhere to perch and somewhere to hide and the sound of purring is everywhere.
These patients often need a chin rub and some eye contact before they will touch their breakfast. More stunning is how, with the right level of calm and mutual respect between these nurses and our cats, the cats don’t resent gentle handling. Rather, they cooperate with being examined and often the purring continues despite the placement of iv catheters, taking of blood and other unpleasant impositions.
Animal-assisted interventions
As psychotherapists, we have a whole world of therapeutic interventions at our disposal. However, animal-assisted interventions (AAIs) are often left unused due to a lack of understanding. In a qualitative study by Wilson et al. (2017), it was found that “the lack of understanding in the wider community about EAP was seen as a barrier to recognition and acceptance of EAP as a valid therapeutic intervention”.
As vets, we are perfectly placed to understand, promote and benefit from AAI. Indeed, we make use of animal-based therapy subconsciously every day […] we receive this therapy despite our perception that our problems don’t reach the threshold of requiring it
As vets, we are perfectly placed to understand, promote and benefit from AAI. Indeed, we make use of animal-based therapy subconsciously every day. Maybe we have no concerns which we feel warrant intervention or therapy. And yet, subconsciously, we receive this therapy despite our perception that our problems don’t reach the threshold of requiring it.
So, what came first? Not needing therapy or the therapy we get every time we have a human–animal interaction precluding our need for other therapy?
AAIs are different to other interventions and can overcome the limitations of human-to-human interaction as they don’t rely on the use of talking and listening as a medium for change.
Equine-assisted psychotherapy
One such AAI I have been fortunate to experience recently is EAP. There are many EAP centres around the country, one of which I visited – Strength and Learning Through Horses (SLTH), based in North London. It may seem bizarre to have this facility where space is prohibitively expensive. Indeed, after many years at this site, due to exponential rent rises they are moving to another space in Barnet in January 2023. It would be easy to move out further to where the rent would be lower, but London is sadly lacking in other such centres. Also, such is the dedication of this team and their determination to make EAP available to all, they are crowdfunding in an effort to make this new space safe and functional.
[The findings of Ward et al. (2017)] suggest a range of improvements within adolescent clients, including increases in confidence, self-esteem and assertiveness, as well as a decrease in undesirable behaviours
EAP comprises a collaborative effort between a licensed therapist and a horse professional working with clients to address treatment goals. In the study by Ward et al. (2017) EAP facilitators’ perspectives on the biopsychosocial benefits and therapeutic outcomes of EAP for adolescents experiencing depression and/or anxiety were examined. Their findings suggest a range of improvements within adolescent clients, including increases in confidence, self-esteem and assertiveness, as well as a decrease in undesirable behaviours. The effectiveness of the therapy was thought to be due to the experiential nature of involving horses in therapy (Ward et al., 2017).
I feel like I deserve to be employed now
Equine therapy client
Experiencing EAP first-hand
I was met by Matt who is the horse professional. Naïvely, I had expected a herd of bomb-proof Thelwell ponies who would be available for brushing and feeding. I know that placing one’s hand on the horse’s thorax to feel the horse’s heartbeat and breathing can be a beautiful mindfulness practice. This, however, was not a herd of docile, jaded little ponies.
Trauma and PTSD, neglect and mistreatment, abuse, inability to trust others, anxiety, fear, anger and loneliness: this may look like a list of human predicaments treated at the centre, but these are just some of the past experiences and present realities of the beautiful horses there. The horses vary in size, age and history. They are magnificent and powerful – some of them are ex-racing thoroughbreds (ie “failures” or “rejects”).
Having grown up with horses and as a vet I like to think of myself as having a connection with animals of all sizes. However, my experience was so humbling as soon as I entered the stables. A massive grey mare greeted me and I went to stroke her. She mistrusted me instantly even though I never did her wrong; she bared her teeth and told me to get lost, which I respected. I soon realised that I have much to learn.
It was so similar to when I meet some teenagers for our first therapeutic session: they can be distrusting, cautious, closed off and angry. At least this horse communicated all of this, something which people often find hard to do.
You can be autistic, bipolar or have a history of abuse. The horse will not judge you for that. The horse is not here to ‘fix’ you; that would be judging you as ‘wrong’
And therein lies the beauty of EAT. It’s hidden in plain sight. Horses often communicate far more clearly than humans. We like to think of ourselves as eloquent and communicative. But with just facial expression and body language, a horse is so honest and truthful, and the young people who come here appreciate this. It may be something they have never experienced before.
Horses are non-judgemental. We have talked about non-judgement in many of these previous articles, especially the articles on mindfulness. Here, whatever your age, gender, race or nationality, the horse is non-judgemental. If you made a mistake at work, let your family down or didn’t turn up for your GCSEs, the horse doesn’t hold it against you.
You can be autistic, bipolar or have a history of abuse. The horse will not judge you for that. The horse is not here to “fix” you; that would be judging you as “wrong”.
I learnt how to prioritise my own mental health. Independence. The staff, dogs and horses make it an amazing environment. I have more resilience than I thought and I am not a bad person. I actually have potential and have a future. Nothing has helped my confidence more than this place
Equine therapy client
Communication
The horse is here to help you to communicate with them, with yourself and with others. Nothing compares with the moments you and your horse are looking at each other, sussing each other out through observing the breath, the body language, the facial expressions and the heart rates of the both of you.
It is true mindfulness, being present in those moments, as well as being so much more than just a mindfulness practice. There is no rush here, unlike the ticking clock in the counsellor’s room where the therapist “hour” is 50 minutes long. You cannot rush an interaction with a horse. It’s physically dangerous and defeats the object of communication.
Matt explained that often, people will confide in their horse once the mutual trust, albeit fragile and temporary, has been established. Matt and the psychotherapist back away at these times to allow for privacy.
The results are remarkable. This is a cohort of very troubled people for whom traditional therapies and medications often haven’t helped. At the centre they don’t cherry-pick their clients. They take on new people based on whose need is the greatest. That, in itself, shows such courage, which is a characteristic we need if we are to be effective therapists.
This gives me the motivation to get through the week. My anxiety is so much less when I am here
Equine therapy client
Collaboration
Matt also explained collaboration. Many of the young people who have therapy at SLTH have been excluded from school or from society in general. They may spend their free time in a virtual world online or just be unable to interact effectively with others because of lack of role models, autism, ADHD or any other cause.
Group therapy here involves small groups coming from many different walks of life. Again, your gender, race and history are accepted in a non-judgemental setting. Sometimes there may be a task set for the young people.
There is no horse riding here. But the horses need to have a halter and rein placed to be led somewhere. This could be the task set for a group of three people, for example: go into the stable of that fearful huge mare, place a halter on her and lead her to the field.
Matt sees people unused to teamwork or cooperation use their various skills to attempt this task. Everyone is good at something. Maybe one person knows their way around a halter and maybe another has established a connection with this horse already and understands their need for slow movements, or non-judgementally accepts the horse’s fear of loud talking. Perhaps the third person can make decisions and bring the group together assigning talents to tasks.
Respect
How Matt and the staff treat the horses with respect and non-judgement is a thing of beauty. There is no mastering of unruly behaviour here. If a horse needs space, they get it. Routines are not rigid because otherwise, a slight routine change could be unsettling to a vulnerable horse who has become reliant on a routine for security. The horses are allowed to graze on the herbs and plants of their choosing (so long as they are safe), listening to their body’s needs. In the new premises, decreased stabling and less rugging up will allow the horses to be more at one with their natural surroundings.
Final thoughts
I’ve seen a lot of horses at riding schools in my time. However, I am very far from being knowledgeable about horses and horse behaviours. What I do remember from my past is seeing lots of crib-biting, weaving, kicking and biting and finally submission to the spurs and crops. Here, there was no stereotypical behaviour to be seen, just behaviours. Despite their traumatic stories, these horses are now as lucky to be here as are the young people they assist.
